Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 244955 | NY |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | D70437 | MD |
NPI | 1912186875 |
---|---|
Provider Name | Dr. Meredith Anne Lazar-Antman |
First Address | Bethpage, NY 11714-3471 |
Second Address | Garden City, NY 11530-1886 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2007 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036684600 | (05) | MD |